Increase In Lung Cancer Mortality Research Articles

Lung cancer mortality trends among women across Spain: the role of birth cohorts in diverging regional patterns

Smoking among Spanish women has increased during the last 50 years and is considered by some authors a modern epidemic. However, mortality risk by cohorts may differ at a regional level, given that health inequalities (and the determinants of smoking and its consequences) are regionally patterned. We applied an Age-Period-Cohort model to identify birth cohort effects on female lung cancer mortality in Spain. We found a strong linear increase in lung cancer mortality during the 1980–2019 period in all regions. Cohorts born between 1935 and 1955 presented a higher relative risk of death at a national and subnational level. However, we found diverging cohort patterns across regions afterward, with some regions presenting a slight mortality improvement (or stagnation) in their youngest cohorts, while in other regions mortality kept increasing. This suggests that inequalities in lung cancer mortality in Spain among women are not only generationally based, but that generational risks also vary across space. Some of the regions that presented improvements in mortality among its younger cohorts are Madrid, Navarra, and the Basque Country, which are some of the wealthiest in the Country. While speculative, this could imply that improvements at a regional level might be associated with factors related to structural conditions that result in the adoption of healthy behaviors.

Mortality for Lung Cancer among PVC Baggers Employed in the Vinyl Chloride Industry.

Vinyl-chloride monomer (VCM) is classified as a known carcinogen of the liver; for lung cancer, some results suggest a potential association with polyvinyl chloride (PVC) dust. We evaluated the relationship between lung cancer mortality and exposure as PVC baggers in a cohort of workers involved in VCM production and polymerization in Porto Marghera (Venice, Italy) considering both employment status and smoking habits. The workers were studied between 1973 and 2017. A subset of them (848 over 1658) was interviewed in the 2000s to collect information about smoking habits and alcohol consumption. Missing values were imputed by the Multivariate Imputation by Chained Equations (MICE) algorithm. We calculated standardized mortality ratios (SMR) and 95% confidence intervals (95% CIs) using regional reference rates by task (never, ever, and exclusively baggers) and by smoking habits. Mortality rate ratios (MRR), adjusted for age, calendar time, time since first exposure, and smoking habits, were obtained via Poisson regression using Rubin’s rule to combine results from imputed datasets calculating the fraction of information due to non-response. Lung cancer mortality was lower than the regional reference in the whole cohort (lung cancer SMR = 0.92; 95% CI 0.75–1.11). PVC baggers showed a 50% increase in lung cancer mortality compared to regional rates (SMR = 1.48; 95% CI 0.82–2.68). In the cohort analyses, a doubled risk of lung cancer mortality among PVC baggers was confirmed after adjustment for smoking and time-dependent covariates (MRR = 1.99, 95% CI 1.04–3.81). Exposure to PVC dust resulting from activity as bagger in a polymerization PVC plant was associated with an increase in lung cancer mortality risk after adjustment for smoking habits.

Lung cancer in Kazakhstan:
 age-gender features

Relevance: Over the years, lung cancer (LC) remains
 the leading cause of cancer deaths in Kazakhstan. In
 2018, LC was diagnosed in 3741 people in the RK, and
 2377 dies from LC.
 The purpose of this study was to assess the age-gender characteristics of morbidity and mortality from LC in
 Kazakhstan based on statistical and literature data.
 Results: The conducted analysis by gender and age
 showed a consistent and significant increase in LC mortality in the RK, starting from the age of 40-44 years. The
 highest incidence and mortality were registered in the age
 groups of 65-69 years and 70+ years. In general, in all age
 categories, the incidence and mortality in men exceeded
 the incidence and mortality in women by 4.5–5.3 times.
 The highest mortality in men and women of all ages was
 registered in 2009 (34.3‰₀₀ and 6.9‰₀₀, respectively), the
 lowest – in 2019 (20.8‰₀₀ in men and 4.6‰₀₀ in women).
 Conclusions: The results of the assessment can be
 used to improve early diagnosis of LC and in the preparation of national screening programs and regional pilot
 projects for LC prevention and the identification of risk
 groups. The use of the results will contribute to increasing
 the effectiveness of treatment, improving the five-year
 survival of patients, reducing the level of neglect and mortality from LC.

Lung cancer in Kazakhstan: age-gender features

Relevance: Over the years, lung cancer (LC) remains the leading cause of cancer deaths in Kazakhstan. In 2018, LC was
 diagnosed in 3741 people in the RK, and 2377 dies from LC.
 The purpose of this study was to assess the age-gender characteristics of morbidity and mortality from LC in Kazakhstan
 based on statistical and literature data.
 Results: The conducted analysis by gender and age showed a consistent and significant increase in LC mortality in the RK,
 starting from the age of 40-44 years. The highest incidence and mortality were registered in the age groups of 65-69 years and
 70+ years. In general, in all age categories, the incidence and mortality in men exceeded the incidence and mortality in women by
 4.5–5.3 times. The highest mortality in men and women of all ages was registered in 2009 (34.3‰ and 6.9‰, respectively), the
 lowest – in 2019 (20.8‰ in men and 4.6‰ in women).
 Conclusions: The results of the assessment can be used to improve early diagnosis of LC and in the preparation of national
 screening programs and regional pilot projects for LC prevention and the identification of risk groups. The use of the results
 will contribute to increasing the effectiveness of treatment, improving the five-year survival of patients, reducing the level of
 neglect and mortality from LC.

Lung Cancer Mortality in China: Spatial and Temporal Trends Among Subpopulations

Background: Little is known regarding spatial and temporal trends of lung cancer mortality (LCM) among subpopulations in China. The study identified the changing spatial and temporal patterns of LCM across China as a whole and in different subpopulations (ie., region, age, and sex). Methods: The data on LCM for the period of 2006 to 2015 by region, age, and sex were extracted from the Chinese National Death Surveillance. Joinpoint regression and seasonal decomposition were used to assess the temporal trends of LCM. Geographic information system and spatial kriging interpolation were used to examine the spatial distributions of LCM. Findings: LCM was highest in men aged 70+ (annual average mortality rate 397·2 (95%CI (394·6-399·8)) per 100,000 person-years). LCM rate in men aged 30 to 49 significantly declined from 2009 to 2015 (annual percentage change: -2·7%, P<0·05). However, LCM continued to rise in men aged 70+ and women aged 50+ in the east, men and women aged 50 to 69 in the south, and most groups in the southwest. Among provincial capital cities, Shenyang, Changsha, and Hohhot had the highest ten-year average LCM rates for men aged 30 to 49, 50 to 69, and 70+, respectively, while among all ages of women, Harbin had the highest ten-year average LCM rates. When dividing the period by 5 years, the odds of the increases in LCM in men and women aged 30 to 49 and 50 to 69 decreased by 3% to 7% with the longitudes increasing by 1° (OR ranged from 0·93 (95%CI 0·90-0·95) to 0·97 (95%CI 0·95-0·99)), and decreased by 5% to 6% with the latitudes increasing by 1° (OR ranged from 0·94 (95%CI 0·91-0·97) to 0·95 (95%CI 0·92-0·98)). Interpretation: Disparities in the spatial and temporal patterns of LCM among different subpopulations support the need for long-term LC surveillance covering larger geographical areas in China and the need for exploration of possible socio-environmental drivers in a spatiotemporal context. Further investigation into the potential risk factors for rising LCM are urgently required in the east, south, and southwest of China. Funding Statement: For continuous support and assistance, we thank Peng Yin, Jiangmei Liu, and Yunning Liu (National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention). We thank all research staff from local Center for Disease Control and Prevention for collection of data. N Wang was supported by the Queensland University of Technology Postgraduate Research Award and Queensland University of Technology Higher Degree Research International Tuition Fee Sponsorship. K Mengersen is supported by the ARC Center of Excellence in Mathematics and Statistical Frontiers. M Kimlin is supported through a Cancer Council Queensland Professorial Chair. W Hu is supported by ARC future fellowship (FT140101216). Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The study has been approved by the Human Research Ethics Committee of Queensland University of Technology (Reference No. 1700001107).

Evidence That Established Lung Cancer Mortality Disparities in American Indians Are Not Due to Lung Cancer Genetic Testing and Targeted Therapy Disparities

BackgroundAmerican Indians and Alaska Natives (AI/AN) continue to experience extreme lung cancer health disparities. The state of Minnesota is home to over 70,000 AI/AN, and this population has a 2-fold increase in lung cancer mortality compared to other races within Minnesota. Genetic mutation testing in lung cancer is now a standard of high-quality lung cancer care, and EGFR mutation testing has been recommended for all adenocarcinoma lung cases, regardless of smoking status. However, genetic testing is a controversial topic for some AI/AN. Patients and MethodsWe performed a multisite retrospective chart review funded by the Minnesota Precision Medicine Grand Challenge as a demonstration project to examine lung cancer health disparities in AI/AN. We sought to measure epidemiology of lung cancer among AI receiving diagnosis or treatment in Minnesota cancer referral centers as well as rate of EGFR testing. The primary outcome was the rate of EGFR mutational analysis testing among cases and controls with nonsquamous, non–small-cell lung cancer. We secured collaborations with 5 health care systems covering a diverse geographic and demographic population. ResultsWe identified 200 cases and 164 matched controls from these sites. Controls were matched on histology, smoking status, sex, and age. In both groups, about one third of subjects with adenocarcinoma received genetic mutation testing. ConclusionThere was no significant difference in mutation testing in AI compared to non-AI controls at large health care systems in Minnesota. These data indicate that other factors are likely contributing to the higher mortality in this group.

Lung cancer mortality in Montenegro, 1990 to 2015

AimTo analyze the trend of lung cancer mortality in Montenegro from 1990 to 2015.MethodsData on lung cancer mortality were collected from death certificates obtained from the Statistical Office of Montenegro for the period 1990-2009 and the Institute for Public Health for the period 2010-2015. Population data were obtained from the Statistical Office of Montenegro. Rates were age-standardized to the World Standard Population, and mortality trends were analyzed with the joinpoint regression.ResultsIn 2015, lung cancer accounted for 5.44% of all deaths and 22.92% of all cancer deaths. It was the leading cause of all cancer deaths and the third-leading cause of all deaths. A joinpoint was observed in 2004 in women and in the entire population, and in 2005 in men. The overall mortality rates increased from 1990 to 2004 by an average of 3.91% per year and decreased from 2004 to 2015 by an average of 1.95%; which in the entire observed period resulted in an average increase of 1.3% per year. A particularly strong growth rate was observed in women, even 7.14% in the period from 1990 to 2004.ConclusionThe observed increase in lung cancer mortality warrants improved tobacco control.

Mortality from cancer and other causes among Italian chrysotile asbestos miners

ObjectiveTo investigate the long-term mortality of a cohort of Italian asbestos miners.MethodsThe cohort included 1056 men employed in a chrysotile mine between 1930 and 1990, who were followed up during...

Is beryllium-induced lung cancer caused only by soluble forms and high exposure levels?

ObjectivesThe US Occupational Safety and Health Administration (OSHA) recently proposed a permissible exposure limit of 0.2 µg/m3 for beryllium, based partly on extrapolated estimates of lung cancer risk from a...

Reproductive Hormones and Their Receptors May Affect Lung Cancer

Background/Aims: In contrast to men, women have experienced a rapid increase in lung cancer mortality. Numerous studies have found that the sex differences in lung cancer are due to reproductive hormones. Experiments in female mice with and without ovariectomy were performed to explore the possible mechanism by which sex hormones (and their receptors) influence lung cancer. Methods: Twenty-four female C57BL/6 mice aged 56-62 days were randomly divided into the ovariectomized group and the control group. In the ovariectomized group, the bilateral ovaries were removed via the dorsal approach, while the control group underwent a sham operation with bilateral ovarian fat resection at the same sites. After 3 weeks of recovery, Lewis lung cancer cells were transplanted into these mice by subcutaneous inoculation of a tumour cell suspension to establish the ovariectomized lung cancer model. Beginning on the 6^th day after subcutaneous inoculation, mouse weight and transplanted tumour volume were measured every 3 days. After 3 weeks, all the mice were killed by cervical dislocation, and we measured the tumour weight. Mouse serum and tumour tissues were removed. Then, the serum levels of E₂ (oestradiol) and T (testosterone) were detected by ELISA; the protein expression levels of AR (androgen receptor), ERα (oestrogen receptor α) and ERβ (oestrogen receptor β) were detected by Western Blot and IHC (immunohistochemistry); and the mRNA expression levels of AR, ERα and ERβ were detected by qRT-PCR (quantitative real-time polymerase chain reaction) in the ovariectomized and control groups. Results: Compared with the control group, both mouse weight and transplanted tumour volume increased rapidly in the ovariectomized group, and the transplanted tumour weight was significantly heavier in the ovariectomized group (1.83±0.40 and 3.13±0.43, P<0.05). E2 and T serum levels decreased exponentially in the ovariectomized group, while the E₂/T ratio increased compared with the control group (E₂: 55.88±11.45 and 78.21±9.37; T: 0.82±0.14 and 1.46±0.16; ratio: 69.62±14.43±29.81 and 52.22±5.42; all P<0.05). The Western blot and IHC results indicated that AR, ERα and ERβ protein expression levels were obviously higher in transplanted tumour and lung tissues from the ovariectomized group, with particular increases in ERβ in transplanted tumour tissue and in ERα in lung tissue. The PCR results also showed markedly higher mRNA expression levels of AR, ERα and ERβ in the ovariectomized group, and in particular, ERβ in transplanted tumour tissue and ERα in lung tissue were significantly increased in the ovariectomized group. Conclusion: Ovariectomy decreased E₂ and T serum levels and increased the E₂/T ratio in mice, and this imbalance in the internal environment promoted the growth of transplanted tumours. Sex hormone disorder not only promoted transplanted tumour growth but also significantly reduced the protein and mRNA expression levels of sex hormone receptors. The metabolism of E₂ and T may affect the growth, proliferation and metabolism of lung cancer cells, and the mechanism by which sex hormones and their receptors influence lung cancer is worthy of further research.

A mortality study of beryllium workers.

We aimed at investigating mortality among beryllium‐exposed workers, according to solubility of beryllium and beryllium compounds. We conducted an historical cohort study of 16,115 workers employed during 1925–2008 in 15 facilities, including eight entailing exposure to insoluble beryllium and seven entailing exposure to soluble/mixed beryllium compounds, who were followed up for mortality until 2011. Data were analyzed using indirect standardization and Cox regression modeling. Lung cancer standardized mortality ratio (SMR, national reference rates) was 1.02 (95% confidence interval [CI]: 0.94–1.10) in the whole cohort, 0.88 (95% CI: 0.75–1.03) in the insoluble beryllium subcohort, and 1.09 (95% CI: 0.99–1.09) in the soluble/mixed beryllium subcohort. For lung cancer, there was an association with period of hire in soluble/mixed beryllium plants but not in insoluble plants, and, conversely, employment in soluble/mixed plants was associated with increased mortality only among workers hired before 1955. There was no trend with duration of employment. Mortality from chronic beryllium disease increased, in particular, among workers hired before 1955 in soluble/mixed beryllium facilities. There was no increase in lung cancer mortality in the entire cohort and lung cancer mortality was not increased among beryllium workers hired in 1955 or later in soluble/mixed beryllium facilities, or at any time among those employed in insoluble beryllium facilities.

Long-term exposure to urban air pollution and lung cancer mortality: A 12-year cohort study in Northern China

Cohort evidence that links long-term exposures to air pollution and mortality comes largely from the United States and European countries. We investigated the relationship between long-term exposures to particulate matter <10μm in diameter (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2) and mortality of lung cancer in Northern China. A cohort of 39,054 participants were followed during 1998–2009. Annual average concentrations for PM10, NO2, and SO2 were determined based on data collected from central monitoring stations. Lung cancer deaths (n=140) were obtained from death certificates, and hazard ratios (HRs) were estimated using Cox proportional hazards models, adjusting for age, gender, BMI, education, marital status, smoking status, passive smoking, occupation, alcohol consumption, etc. Each 10mg/m3 increase in PM10 concentrations was associated with a 3.4%–6.0% increase in lung cancer mortality in the time-varying exposure model and a 4.0%–13.6% increase in the baseline exposure model. In multi-pollutant models, the magnitude of associations was attenuated, most strongly for PM10. The association was different in men and women, also varying across age categories and different smoking status. Substantial differences exist in the risk estimates for participants based on assignment method for air pollution exposure.

Differences Between Men and Women in Time Trends in Lung Cancer Mortality in Spain (1980–2013)

IntroductionThe main risk factor for lung cancer is smoking, a habit that varies according to age and sex. The objective of this study was to explore trends in lung cancer mortality by sex and age from 1980 to 2013 in Spain. MethodsWe used lung cancer mortality (International Classification of Diseases code 162 for the 9th edition, and codes C33 and C34 for 10th edition) and population data from the Spanish National Statistics Institute. Crude, truncated, age-adjusted mortality and age-specific mortality rates were assessed through joinpoint regression to estimate the annual percent change (APC). ResultsAge-adjusted mortality rate significantly increased from 1980 to 1991 among men (APC=3.12%) and significantly decreased between 2001 and 2013 (APC=−1.53%), a similar pattern was observed in age-specific rates. Among women, age-adjusted mortality rate increased from 1989 (APC 1989–1997=1.82%), with the greatest increase observed from 1997 until the end of the study in 2013 (APC=4.41%). ConclusionsDiverging trends in the prevalence of smoking could explain the increase in the rate of lung cancer-related mortality among Spanish women since the early 1990s. Public health policies should be implemented to reduce tobacco consumption in women and halt the increase in lung cancer mortality.

Diferencias entre hombres y mujeres en la tendencia temporal de la mortalidad por cáncer de pulmón en España (1980-2013)

IntroductionThe main risk factor for lung cancer is smoking, a habit that varies according to age and sex. The objective of this study was to explore trends in lung cancer mortality by sex and age from 1980 to 2013 in Spain. MethodsWe used lung cancer mortality (International Classification of Diseases code 162 for the 9th edition, and codes C33 and C34 for 10th edition) and population data from the Spanish National Statistics Institute. Crude, truncated, age-adjusted mortality and age-specific mortality rates were assessed through joinpoint regression to estimate the annual percent change (APC). ResultsAge-adjusted mortality rate significantly increased from 1980 to 1991 among men (APC=3.12%) and significantly decreased between 2001 and 2013 (APC=−1.53%), a similar pattern was observed in age-specific rates. Among women, age-adjusted mortality rate increased from 1989 (APC 1989-1997=1.82%), with the greatest increase observed from 1997 until the end of the study in 2013 (APC=4.41%). ConclusionsDiverging trends in the prevalence of smoking could explain the increase in the rate of lung cancer-related mortality among Spanish women since the early 1990s. Public health policies should be implemented to reduce tobacco consumption in women and halt the increase in lung cancer mortality.

Total and cause-specific mortality of U.S. nurses working rotating night shifts.

Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases. To examine associations between rotating night shift work and all-cause; cardiovascular disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses' Health Study. Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988-2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs. All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6-14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no significant association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.98, 1.19) or mortality of any individual cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51). Women working rotating night shifts for ≥5 years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.

Abstract 2178: Rotating night shift work and cancer mortality in the nurses' health study

Abstract Rotating night-shift work is common in western societies, but epidemiological studies on shift work and cancer mortality are limited. In a prospective closed cohort of 74,914 registered US nurses, the Nurses' Health Study, we examined the impact of rotating night-shift work on total-cancer and cancer-specific mortality. Rotating night-shift work was defined as having worked at least 3 nights per month. Cox proportional hazards models adjusting for age, smoking, BMI, and other important confounders, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 22 years of follow-up, we documented 5,123 cancer deaths. Overall, we observed no association between rotating night-shift work and total-cancer mortality (HR15+years=1.07; 95% CI, 0.97-1.19; Ptrend=0.17). However, women with 15 or more years of night-shift work had a significant increase in lung cancer mortality (multivariable HR=1.25; 95% CI, 1.04-1.50) and a borderline significant increase in colorectal cancer mortality (MV HR=1.32; 95% CI, 0.97-1.81). The increase in lung cancer mortality was limited to current smokers. We observed no increase in breast cancer mortality (HR15+years=1.03; 95%CI, 0.76-1.38; Ptrend=0.97). For cancers with fewer than 200 deaths, we observed a non-significant increase in mortality from kidney cancer, myeloma and leukemia among women with 6-14 and 15+ years of rotating night-shift work: the HRs were 1.58 (95% CI, 0.92-2.71) and 1.36 (95% CI, 0.72-2.56) for kidney cancer, 1.66 (95% CI, 0.98-2.81) and 1.47 (95% CI, 0.79-2.77) for myeloma, 1.25 (95% CI, 0.70-2.23) and 1.53 (95% CI, 0.83-2.83) for leukemia, respectively. We conclude that after adjusting for important confounders, the impact of rotating night-shift work on cancer mortality appears modest. Women working rotating night-shifts for more than 15 years had modestly increased colorectal and lung cancer mortality but the increase in lung cancer mortality was largely limited to current smokers and it is possible that these observations remain residually confounded by smoking. Additional studies are warranted to confirm our findings. Citation Format: Fangyi Gu, Jiali Han, Sue Hankinson, Eva Schernhammer, Nurses' Health Study Group. Rotating night shift work and cancer mortality in the nurses' health study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2178. doi:10.1158/1538-7445.AM2014-2178

Abstract 2180: Serum 25-hydroxyvitamin D, vitamin D binding protein, and lung cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study

Abstract Background: Vitamin D may inhibit tumor progression by suppressing metastasis, proliferation, and angiogenesis. The vitamin D binding protein (DBP) is the primary carrier of circulating vitamin D compounds and functions in actin scavengering, macrophage activation, and neutrophil chemotaxis. Little is known about the association between vitamin D, DBP, and lung cancer survival. We investigated the association between serum concentrations of 25-hydroxyvitamin D (25(OH)D), DBP, and lung cancer mortality in 500 lung cancer cases from the ATBC Study. Methods: Serum concentrations of 25(OH)D, DBP, and the molar ratio of 25(OH)D:DBP, a proxy for free circulating vitamin D, were measured in fasting blood samples collected at baseline. Hazards ratios (HR) and 95% confidence intervals (CI) were used to estimate survival by quartiles of 25(OH)D, DBP, and the 25(OH)D:DBP molar ratio. Results: Median survival time was 0.5 years (IQR: 0.1 - 1.1) for 428 cases that died from lung cancer and 1.7 years (IQR: 0.1 - 7.8) for 72 lung cancer survivors. Median serum concentrations (nmol/L) of 25(OH)D and DBP were 33 (IQR: 20-50) and 5951 (IQR: 4725-7196), respectively, for lung cancer deaths and 37 (IQR: 22-52) and 5431 (IQR: 4600-7151), respectively, for lung cancer survivors. In multivariable adjusted models, higher concentrations of serum 25(OH)D were associated with a small but not statistically significant increase in lung cancer mortality (Q4 vs. Q1 HR = 1.20; 95% CI: 0.90, 1.60). Survival was not associated with higher serum concentrations of DBP (Q4 vs. Q1 HR = 1.01; 95% CI: 0.76, 1.34). A higher 25(OH)D:DBP molar ratio was associated with a slightly reduced risk of mortality, although not significant (Q4 vs. Q1 HR = 0.87; 95% CI: 0.65, 1.18). DBP concentration did not modify the association between 25(OH)D or the 25(OH)D:DBP molar ratio and lung cancer survival. In histology-specific analyses, elevated concentrations of 25(OH)D was associated with higher mortality in squamous cell carcinomas (HR = 1.47; 95% CI: 0.82, 2.65) and adenocarcinomas (HR = 1.42; 95% CI: 0.33, 6.05), but reduced mortality in small cell carcinomas (HR = 0.62; 95% CI: 0.18, 2.10). A higher 25(OH)D:DBP molar ratio was associated with higher mortality for squamous cell tumors (HR = 1.28; 95% CI: 0.68, 2.40), and lower mortality for adenocarcinomas (HR = 0.10; 95% CI: 0.02, 0.57) and small cell tumors (HR = 0.52; 95% CI: 0.12, 2.18). Associations between serum DBP and mortality were similar across histologic types. Conclusion: Higher vitamin D status was weakly associated with lung cancer survival and DBP was unrelated to survival; however, a higher 25(OH)D:DBP molar ratio indicative of unbound or “free” vitamin D may be related to increased adenocarcinoma and possibly small cell carcinoma survival. The findings should be evaluated in other longitudinal studies. Citation Format: Gabriella M. Anic, Stephanie J. Weinstein, Satu Männistö, Demetrius Albanes. Serum 25-hydroxyvitamin D, vitamin D binding protein, and lung cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2180. doi:10.1158/1538-7445.AM2014-2180

PM&amp;lt;sub&amp;gt;2.5&amp;lt;/sub&amp;gt; Pollution and Risk for Lung Cancer: A Rising Issue in China

This study is focused on the linkage between lung cancer incidence rates and PM2.5 pollution. Researches conducted by leading research organizations in U.S. and Europe were reviewed and analyzed, and strong evidence exists that elevated fine particulate air pollution exposures are associated with significant increases in lung cancer mortality. The linkage between fine particulate air pollution and lung cancer motility is observed even after controlling for cigarette smoking, occupational exposure, and other risk factors. This finding is in alignment with observations in China which show an upward trend of lung cancer incidences coupled with a downward trend in the number of smokers. Currently, China lacks systematic research on the effect of PM2.5 on lung cancer. As a result, this paper investigated studies on the linkage between pollution and lung cancer incidence from decades of research conducted in the U.S. and Europe. One important step in solving this issue in China is through classifying PM2.5 pollution as a human cacinogen. Adequate government regulation, public awareness, regional collaboration and industrial compliance are also key to the successful control of PM2.5 pollution and smog.

Arsenic in drinking and lung cancer mortality in Taiwan

The association between exposure to arsenic in drinking water and lung cancer has been observed in some epidemiology studies, but dose–response data are limited. To assess the dose–response relationship and identify hot spots, we analyzed the national death registry data of Taiwan from 1971 to 2000. We adopted data on 311 townships gathered by a nationwide survey of drinking water and divided arsenic levels into three groups: below 0.05mg/L, 0.05–0.35mg/L, and above 0.35mg/L. Using the direct standardization method to adjust for the effects of age, we calculated the standardized mortality rates of lung cancer in both genders and evaluated their associations with arsenic levels. We also used the geographical information system to identify the hot spots. During the 30-year study period, we identified 64,954 male and 27,039 female lung cancer deaths in the study townships. We found significant increases in lung cancer mortality associated with arsenic levels above 0.35mg/L in both genders, but the increases associated with levels between 0.05 and 0.35mg/L were statistically significant in men only. Using both 0.05 and 0.35mg/L as the cut-offs, we found most of the hot spots were in the southwestern coast and northeastern areas, but the southwestern coast area had some hot spots where the percentages of high risk population were higher than any hot spots in the northeastern area.

Residential Segregation and Lung Cancer Mortality in the United States

To examine the relationship between race and lung cancer mortality and the effect of residential segregation in the United States. A retrospective, population-based study using data obtained from the 2009 Area Resource File and Surveillance, Epidemiology and End Results program. Each county in the United States. Black and white populations per US county. A generalized linear model with a Poisson distribution and log link was used to examine the association between residential segregation and lung cancer mortality from 2003 to 2007 for black and white populations. Our primary independent variable was the racial index of dissimilarity. The index is a demographic measure that assesses the evenness with which whites and blacks are distributed across census tracts within each county. The score ranges from 0 to 100 in increasing degrees of residential segregation. RESULTS The overall lung cancer mortality rate was higher for blacks than whites (58.9% vs 52.4% per 100 000 population). Each additional level of segregation was associated with a 0.5% increase in lung cancer mortality for blacks (P < .001) and an associated decrease in mortality for whites (P = .002). Adjusted lung cancer mortality rates among blacks were 52.4% and 62.9% per 100 000 population in counties with the least (<40% segregation) and the highest levels of segregation (≥60% segregation), respectively. In contrast, the adjusted lung cancer mortality rates for whites decreased with increasing levels of segregation. Lung cancer mortality is higher in blacks and highest in blacks living in the most segregated counties, regardless of socioeconomic status.